Evaluation of the Effect of the Inspired Oxygen Fraction on Blood Oxygenation during Inhalant Anaesthesia in Horses: A Systematic Review with Meta-Analysis

Savvas, Ioannis; Pavlidou, Kiriaki; Braun, Christina; Schauvliege, Stijn; Staffieri, Francesco; Moens, Yves

doi:10.3390/ani11082245

Cited by 4 publications

(2 citation statements)

References 47 publications

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“…Decreasing the FiO2 in horses during anaesthesia has various results. While lower FiO2 decreases the alveolararterial oxygen gradient (P(A-a)O2) it has a negative impact on the oxygenation, thus higher FiO2 in horses during inhalation anaesthesia will result in higher oxygen levels in the blood (Savvas et al 2021).…”

Section: Background 21 Hypoxaemiamentioning

confidence: 99%

Clinical implementation of Pulsed inhaled Nitric Oxide in equine anaesthesia

Wiklund¹

2023

Acta Universitatis Agriculturae Sueciae

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Hypoxaemia is a common complication during horse anaesthesia that is a challenge to treat. The primary cause of hypoxaemia is the development of a large intrapulmonary shunt that leads to significant ventilation-perfusion mismatch. Opening and ventilating atelectasis during anaesthesia requires high airway pressures and repeated manoeuvres. Another approach to improve gas exchange in the lung is to redistribute blood flow from atelectatic to well-ventilated lung regions. In experimental studies, it has been shown possible to target the vasodilating gas nitric oxide to open ventilated lung parts by pulsing the gas at the beginning of inspiration. In the first experimental study of the present thesis, the effect of Pulsed inhaled Nitric Oxide (PiNO) was evaluated during different modes of ventilation in combination with normal or low cardiac output and blood pressure. In the following clinical studies, PiNO was evaluated in colic horses undergoing abdominal surgery and in healthy horses undergoing arthroscopy. In the last study, it was investigated if PiNOinduced improved arterial oxygenation had an impact on the quality of recovery after anaesthesia compared to controls. The results showed that PiNO was effective during mechanical ventilation only if cardiac output blood pressure were adequate, while PiNO was effective under both hypotensive and normotensive conditions during spontaneous breathing. In the clinical studies, PiNO effectively improved arterial oxygenation in both healthy and colic horses, ventilated spontaneously or mechanically. In the last study, horses that received PiNO during anaesthesia had better recovery quality compared to controls. In addition, a positive correlation between arterial oxygenation during anaesthesia and recovery quality was seen. In summary, PiNO offers a simple and effective option to treat hypoxaemia in anaesthetised horses. In the future, the effect of oxygenation on the quality of recovery needs to be further investigated as well as the long-term effects, such as wound healing in the postoperative period.

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Section: Background 21 Hypoxaemiamentioning

confidence: 99%

Clinical implementation of Pulsed inhaled Nitric Oxide in equine anaesthesia

Wiklund¹

2023

Acta Universitatis Agriculturae Sueciae

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“…Although elevated FIO 2 readily corrects hypoxemia produced by high alveolar carbon dioxide tension and V/Q mismatch, its use may encourage the formation of absorption atelectasis (2)(3)(4)(5). Thus, the use of FIO 2 < 1 has been investigated, although findings are mixed as to its benefit and may be species dependent [e.g., see (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)]. Furthermore, the use of elevated FIO 2 in animals that are hypoxemic secondary to abnormally high venous admixture masks, rather than treats, the underlying causes (i.e., pulmonary shunt and excessive low V/Q mismatching).…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary effects of apneustic anesthesia ventilation in anesthetized pigs: a new mode of ventilation for anesthetized veterinary species

Bukoski,

Downs,

Hodgson

et al. 2024

Front. Vet. Sci.

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ObjectiveTo compare the cardiopulmonary effects of apneustic anesthesia ventilation (AAV) and conventional mechanical ventilation (CMV) in anesthetized pigs and to describe a new mode of ventilation for anesthetized veterinary species.Study designRandomized, crossover design without washout.AnimalsTwelve healthy, female white Landrace pigs.MethodsFollowing ketamine-midazolam premedication and anesthetic induction with propofol, the trachea was intubated, and each pig was positioned in dorsal recumbency. Anesthesia was maintained with propofol and sufentanil infusions. Pigs were instrumented and their lungs were sequentially ventilated with each mode, in random order, for 1 h according to predefined criteria [fraction of inspired oxygen (FiO2) = 0.21, 10 mL kg−1 tidal volume (VT), and arterial carbon dioxide tension (PaCO2) within 40–45 mmHg]. Cardiopulmonary data were collected at baseline, 30 and 60 min. In 8 pigs, thoracic computed tomography (CT) was performed following the 60 min time point for each mode of ventilation and images were analyzed to quantify lung aeration. The effects of ventilation mode, time, and order were analyzed using repeated measures ANOVA. Paired t-tests were used to compare lung aeration between modes. Significance was defined as p < 0.05.ResultsData from 12 pigs were analyzed. A significant effect of mode was found for heart rate, mean arterial pressure (MAP), pulmonary artery occlusion pressure, cardiac index (CI), stroke volume index, systemic vascular resistance, pulmonary vascular resistance, oxygen delivery index (DO2I), oxygen extraction ratio (O2ER), VT, arterial oxygen tension, arterial hemoglobin saturation, PaCO2, end-tidal carbon dioxide tension, alveolar dead space (VDalv/VTalv), venous admixture (Q.s/Q.t), mean airway pressure, and dynamic compliance index (CRSI). Order effects were also observed for some cardiovascular and respiratory variables. For the eight pigs that underwent thoracic CT, AAV resulted in significantly larger proportions of normally and hyperaerated lung while CMV resulted in larger proportions of hypoaerated and atelectatic lung.ConclusionsIn dorsally recumbent anesthetized pigs, ventilated with FiO2 = 0.21, both modes of ventilation supported adequate oxygenation while AAV resulted in higher CRSI, and lower VDalv/VTalv and Q.s/Q.t, compared with CMV. AAV was also associated with lower MAP, CI, and DO2I and higher O2ER compared with CMV. Further investigation of AAV in anesthetized animals is warranted.

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Comparative Anesthesia and Analgesia – Horses

Bidwell

2024

Veterinary Anesthesia and Analgesia

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Evaluation of the Effect of the Inspired Oxygen Fraction on Blood Oxygenation during Inhalant Anaesthesia in Horses: A Systematic Review with Meta-Analysis

Cited by 4 publications

References 47 publications

Clinical implementation of Pulsed inhaled Nitric Oxide in equine anaesthesia

Clinical implementation of Pulsed inhaled Nitric Oxide in equine anaesthesia

Cardiopulmonary effects of apneustic anesthesia ventilation in anesthetized pigs: a new mode of ventilation for anesthetized veterinary species

Comparative Anesthesia and Analgesia – Horses

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